The Halifax Interlaminar Clamp for Posterior Cervical Fusion

Statham, Patrick; O’Sullivan, M. Gerard; Russell, Thomas

doi:10.1227/00006123-199303000-00009

Cited by 35 publications

(5 citation statements)

References 7 publications

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“…However, the interlaminar clamp is not effective when laminae are fractured or there is rotational instability. The failure rate of fusion is as high as 20% 24 . Anterior odontoid screw fixation was performed in our series during 2005–2010 in most patients with type II and type III odontoid fractures with intact transverse ligaments and OC fusion in patients with degenerative osteoarthritis and RA.…”

Section: Discussionmentioning

confidence: 89%

“…The failure rate of fusion is as high as 20%. 24 Anterior odontoid screw fixation was performed in our series during 2005-2010 in most patients with type II and type III odontoid fractures with intact transverse ligaments and OC fusion in patients with degenerative osteoarthritis and RA. Odontoid fractures account for 20% of all cervical spine fractures.…”

Section: Discussionmentioning

confidence: 94%

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Advances in surgical treatment for atlantoaxial instability focusing on rheumatoid arthritis: Analysis of a series of 67 patients

et al. 2023

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AimAn estimated 88% of rheumatoid arthritis (RA) patients experience various degrees of cervical spine involvement. The excessive movement of the atlantoaxial joint, which connects the occiput to the upper cervical spine, results in atlantoaxial instability (AAI). AAI stabilization is usually achieved by C1 lateral mass‐to‐C2 pedicle screw‐rod fixation (LC1–PC2 fixation), which is technically challenging in RA patients who often show destructive changes in anatomical structures. This study aimed to analyze the clinical results and operative experiences of C1–C2 surgery, with emphasis on the advancement of image‐guided surgery and augmented reality (AR) assisted navigation.MethodsWe presented our two decades of experience in the surgical management of AAI from April 2004 to November 2022.ResultsWe have performed surgery on 67 patients with AAI, including 21 traumatic odontoid fractures, 20 degenerative osteoarthritis, 11 inflammatory diseases of RA, 5 congenital anomalies of the os odontoideum, 2 unknown etiologies, 2 movement disorders, 2 previous implant failures, 2 osteomyelitis, 1 ankylosing spondylitis, and 1 tumor. Beginning in 2007, we performed LC1–PC2 fixation under C‐arm fluoroscopy. As part of the progress in spinal surgery, since 2011 we used surgical navigation from presurgical planning to intraoperative navigation, using the preoperative computed tomography (CT) ‐based image‐guided BrainLab navigation system. In 2021, we began using intraoperative CT scan and microscope‐based AR navigation.ConclusionThe technical complexities of C1–C2 surgery can be mitigated by CT‐based image‐guided surgery and microscope‐based AR navigation, to improve accuracy in screw placement and overall clinical outcomes, particularly in RA patients with AAI.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 94%

Advances in surgical treatment for atlantoaxial instability focusing on rheumatoid arthritis: Analysis of a series of 67 patients

et al. 2023

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“…elderly patients with fractures or patients with rheumatoid arthritis), the bone quality does not allow optimal fixation with these techniques, which is why additional external fixation such as a halo vest frequently has to be added [8]. Various hook devices have been introduced, such as the Halifax clamp, but the stability and longevity of these systems have not proven to be ideal for C1-C2 fixation [37]. one-point fixations) are, however, not effective against rotatory and lateral bending moments [10,20].…”

Section: Discussionmentioning

confidence: 99%

Posterior atlanto-axial fusion with the Olerud Cervical Fixation System for odontoid fractures and C1-C2 instability in rheumatoid arthritis

et al. 2003

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IntroductionPosterior C1-C2 fusion is used to treat fractures and nonunions of the odontoid and in rheumatoid C1-C2 instability. Other rarer indications are traumatic lesions of the transverse ligament [11], ligament laxity in Down or Marfan syndromes [6,21,22] or congenital deformity (i.e. os odon-toideum) [9,13]. The methods used for treatment of odontoid fractures include both nonsurgical methods such as immobilization in a halo vest [27,34,35] or Philadelphia collar [34] and surgical methods such as anterior screw fixation [2,4]. However, disadvantages and complications have been demonstrated with all these treatment methods, especially in elderly patients [3,5,16,24,26,30,33,34,36].Abstract In posterior C1-C2 fusion, traditional wire fixation gives poor stability. The bone quality is often insufficient to provide the competent structural bone graft that is required, and the introduction of sublaminar wires is somewhat dangerous. The stability is markedly improved by adding transarticular screws, but the drawbacks of structural bone graft and sublaminar wires remain. The C1 claw of the Olerud Cervical Fixation System improves C1-C2 fixation without relying on structural bone graft or compromising the spinal canal. The aim of this study was to evaluate radiological healing and possible complications in a consecutive series of C1-C2 fusions from our department operated with the C1 claw device. Twenty-six patients (14 women) with a mean age of 73 (range 37-93) years were included. The diagnoses were odontoid fracture in 18 patients, rheumatoid instability in 6, and odontoid non-union and os odontoideum in 1 each. The patients were followed clinically and with plain radiographs for an average of 15 (range 3-27) months. There were no neurological or vascular complications, and no secondary displacements or reoperations in the series. Twenty patients followed for 6-27 months were radiographically healed. Six patients died from unrelated causes 1-38 months postoperatively. Three of these patients had no radiographs later than the postoperative control, one had a healed odontoid fracture but resorbed bone graft at 8 months, while the remaining two patients were not healed, but showed no signs of healing disturbance at the time of death. On the basis of the findings of this study, posterior C1-C2 fusion with the Olerud Cervical Fixation System seems promising. No serious complications related to the surgical procedure were encountered. The stability of the implant obviates the use of a solid bone block as a graft and still allows a high frequency of fusion healing.

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“…The Halifax system is currently not widely used, probably because significant nonunion rates have been reported. 13 The Magerl technique for placement of transarticular screws provides excellent fixation of C1-2, 14 particularly when used in combination with sublaminar wiring. Intact laminae are not required.…”

Section: Atlantoaxial Fusionmentioning

confidence: 99%